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Related Experiment Videos

Effect of systemic antimicrobial prophylaxis on microbial flora.

G P Bodey, B Rosenbaum, M Valdivieso

    Antimicrobial Agents and Chemotherapy
    |March 1, 1982
    PubMed
    Summary

    Antimicrobial prophylaxis with trimethoprim-sulfamethoxazole and other antibiotics reduced aerobic and anaerobic bacteria in patients with oat cell lung cancer. Fungal infections were noted but the regimen was well tolerated.

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    Area of Science:

    • Oncology
    • Infectious Diseases
    • Pharmacology

    Background:

    • Patients with oat cell carcinoma of the lung undergoing intensive chemotherapy are at high risk for infections.
    • Protected environmental units are used to minimize infection risk in immunocompromised patients.
    • Antimicrobial prophylaxis is a key strategy to prevent infections in these vulnerable patients.

    Purpose of the Study:

    • To evaluate the efficacy and tolerability of a specific antimicrobial prophylaxis regimen in patients with oat cell lung cancer.
    • To assess the impact of the prophylaxis on the gut microbiome composition (aerobic and anaerobic bacteria).
    • To monitor for the development of infections, including fungal infections, during the prophylaxis period.

    Main Methods:

    • A cohort of 15 patients with oat cell lung cancer in a protected environmental unit received oral trimethoprim-sulfamethoxazole and short courses of parenteral ticarcillin, tobramycin, and miconazole.

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  • Stool specimens were collected to culture aerobic and anaerobic bacteria before and during prophylaxis.
  • Patients were monitored for bacterial and fungal infections, and side effects.

    • Main Results:

    • Prophylaxis significantly reduced the prevalence of aerobic bacteria (65% reduction) and anaerobic bacteria (60% reduction) in stool specimens.
    • Ten new bacterial strains and four fungal strains were acquired during prophylaxis.
    • Three patients developed Candida esophagitis; however, the regimen was generally well tolerated with minimal side effects.

    Conclusions:

    • The antimicrobial prophylaxis regimen effectively reduced aerobic and anaerobic bacterial colonization in patients with oat cell lung cancer.
    • While fungal infections like Candida esophagitis can occur, the overall regimen demonstrated good tolerability.
    • This prophylaxis strategy may be beneficial in reducing bacterial infections in immunocompromised cancer patients, but careful monitoring for fungal overgrowth is warranted.